I recently underwent a pulmonary vein ablation for atrial fibrillation. I know some people here have had the same procedure – I was wondering what your recovery from the procedure was like?The doctor said it was quite common to experience ‘healing arrhythmias’ after the procedure. How long does it take for these to go away? It’s been two weeks since the operation and, if anything, my bouts of Afib are getting worse instead of better. I’m having episodes that are as bad or worse than prior to the surgery, with continuous Afib for 10-15 hours. My non-arrhythmic heart rate now is quite elevated from my previous resting rate (it’s 70-80 now, rather than 40-50 BPM), and skipped beats/fluttering is quite common. I’m also experiencing some deep, dull pain in my heart and lungs, I assume from things healing the damage of surgery. I’m quite short of breath, to the point where even talking is difficult – I have to take breaks to breathe.So, for anyone out there that has gone through this procedure, what was your recovery like? How long did you have post-procedure arrhythmias? What other pain and symptoms did you experience? How long did it take before you were able to live a ‘normal life’ (i.e. function at work, do household chores, etc.)? How long before you were able to exercise again?I haven’t been able to train consistently or race for about 4 years now, and I haven’t been able to exercise at all for over 6 months. I’ve been dreaming about being able to just go for a walk or an easy bike ride. So far my recovery hasn’t been as smooth as I had hoped…Someone give me some hope here!Thanks,J

Are you still (or were you) on coumadin? You are describing a pulmonary embolism rather well and needs to be checked out ASAP!!! The shortness of breath and the deep, dull pain in the lungs - bad! Call your interventional guy on the way to the ER would be my suggestion ... ____________________________________ Fatigue is biochemical, not biomechanical. - Andrew Coggan, PhD

unfortunately my experience isn't one to give you much hope, but there are others with positive experiences. some report it takes up to 6 months to be feeling better.

i had an ablation (a-flutter) a year ago. a month later, i went into v-tach while riding. result: an ICD (PM + defib) inserted. a month later went into v-tach again (it's like one step removed from sudden cardiac arrest.) so drugs were added to the mix. 3 months ago i had v-tach again so more drugs.

my rides these days are limited to 45-60 minutes @around 14-15 mph. two years ago (@61) i was riding 5hr centuries. don

I don't pretend to know much about medicality, but how dow ablating your pulmonary vein affect conduction?

Anyway, I had two ablations done for supraventricular tachycardia with a few bouts of atrial flutter after the first one. I was back exercising as soon as the entry point on my femoral artery/vein (hell if I know which one) healed. The 1st one was about 2 weeks, The second was about 10 days. The chamois pad seems to end right where they put a hole in you. Very very easy efforts for a month.

Experienced PVCs after both with decreasing frequency over time. Only 15 months between the 2, but they tapered out and I only one every so often, usually lack of sleep / excess caffeine combo. Everything good to go now.

As for your current symptoms, what do you think your cardiologist would say if you described them to him/her? Pain of any kind is a flag. Call 1st thing in the morning. Serious. Maybe even ER tonight. Serious. ---------------------------------------------------

Brawndo's got what plants crave. Brawndo's got electrolytes. And that's what plants crave. They crave electrolytes. Which is what Brawndo has. And that's why plants crave Brawndo. Not water, like from the toilet.

Hope I can offer some encouragement. First a little history: Had a successful ablation for SVT in 4/04. Fifteen months later went into first afib 10 miles into the bike at Eagleman and easy spun in before dropping out of the race after the bike and was cardioverted back to normal sinus the next day. Have been cardioverted seven more times with decreasing intervals between episodes. My cardiologist then said it was time for an afib ablation which primarily targets the area of the pulmonary vein connection to the left atria. I had been avoiding this ablation procedure because of its higher risk and lower success rate than the SVT ablation I had in '04.

It has been 7 weeks today since my afib ablation. On the 8th and 9th day post ablation I experienced a flutter which self corrected after a few hours. On the tenth day post procedure I went into what I thought was afib again, called my Doc and was cardioverted back the next day. It actually was atrial tach which my Doc attributed to the irritation and trauma of the ablation. I did experience the deep burn like irritation for about two weeks after the procedure from the "burn" of the ablation. It was most noticeable when taking a deep, chest expanding breath. I was warned by my Docs about the likelihood of post ablation arrhythmia and chest irritation until the healing process had few weeks to settle things down. My resting heart rate was about 15 beats higher after the ablation and has settled back to normal now. I am pleased to say that I have been symptom free for 5 weeks and feel good. I started running and biking 2 1/2 weeks after the ablation. Runs are in the 3-5 mile range and bike 20-30 at conditioning, not training pace. I am slowly increasing mileage as I gain confidence that the ablation was successful. I know it could be six months until the ablation can be considered a success.

The ablation was performed at the Hosp. of the Univ. of Penna. My age is 63 and have been doing tris for 15 years. Last Ironman was 2002 and been sticking to mainly olys and a few halfs since. I am on Coumadin and Metoporal both of which I hope to be weaned off of in about 4 months. My advice is to give it time, but I would keep a close eye on the chest pain and shortness of breath (I did not experience) if they persist. You want to be sure that there was no collateral damage to adjacent organs by the ablation.

Sorry to dig this one up .......... another recently diagnosed A-Fib patient here and I have been put on Sotalol (80mg, 2x a day). I am not liking what I think are the side effects with being slower. But my cardio. said I should be fine to continue my activities (he knows I'm an endurance athlete). Because I am low risk for everything else on the "chart" he did not feel the need to put me on Cumadin (sp) and only said to do Aspirin - which I haven't yet.

Did your procedure work itself out? Are you out the irregular rhythms yet? _____________________________________________ Rick, "Retired" hobbyist athlete Trying to come back slowly from acute A-Fib

I'm now 3 weeks post procedure and feeling a bit better every day. I still have no idea of how much actual exercise I'll be able to eventually handle, but I was able to walk on a treadmill this morning for 15 min without any issue (yet).

My experience with various drugs to control arryhthmia issues is that they all suck with regards to intense exercise. At various times in my life (in addition to the recent ablation for afib, I also had an ablation for Wolff-parkinson-white syndrome 10 years ago) I've been on digoxin, fleccanide, diltiazem, rythmol, and a few other beta blockers/calcium channel blockers. Most of the drugs seem to remove your top end heart rate and ability to go at a harder effort.

The only time I've felt the drugs were worth the side effects was in the last ~6 months, when my afib had gotten so bad that I had ceased all exercise anyway. In that case the drug (rythmol this time) was effective at reducing the occurance of afib and allowing me to at least function at work, do some household chores, etc. But I don't think I could have successfully trained and raced while on it.

I spent ~3-4 years after my afib developed not on drugs and training as my heart and faituge levels allowed, with occasional 'low-key' races as I felt up to. over that time things gradually got worse with the frequency and duration of afib episodes, and about 8+ months ago things got significantly worse fairly quickly. At that point I decided to go ahead with the ablation surgery.

The surgery is not without risk, side effects, and doesn't have a great chance of success (~60-70% success after a single procedure). I don't know how bad your afib is, but I would wait until it's significantly affecting your life before opting for the surgery. That being said, if training and racing at a high effort level is important to you, I don't know if you'll be able to do so while on any of the controlling drugs.

Good luck, and let me know if you have any questions about my procedure and recovery. I'll post again in a few months to detail my recovery and (hopeful) return to exercise and fitness.

I had an ablation for a-fib Feb. 4th of this year at Johns Hopkins. I developed a-fib at 40 and was cardioverted over 15 times, failed multiple anti-arrythimic drugs...finally had enough...went for the ablation. Post-procedure I had a lot of funny beats, short runs of a-fib (but they converted spontaneously) and lots of chest pain. I developed a "friction rub" heart sound after the procedure indicating 'pericarditis'. I couldn't walk up a flight of stairs without getting short of breath and chest pain. My resting heart rate almost doubled. Tried to swim the first week and couldn't go 200 yards. I thought I made a big mistake. Gradually though, I recovered, began training. Stopped coumadin at 7 weeks and began riding. I'm off all drugs except aspirin. I do not have any sustained a-fib. I rapidly gained fitness. March 14th I did a 5K, 3 minutes slower than usual but I was thrilled. I continued to train and race. To make a long story short, I raced the 70.3 at Buffalo Springs in late June and got a roll down spot to Kona. Two weeks later I raced Providence, RI 70.3, won the age group and had the privelge of rolling down a Kona spot to someone else. It's only been 7 months but I would characterize my ablation results as outstanding! I can train better now, more consistantly and with a higher sustained high heart rate. Hang in there, be patient. Keep training to your tolerance and comfort level. Exercise is still good medicine even if you're in a-fib.

I follow a number of a-fib forums and read up on it quite a bit as a layman. I don't know if this qualifies as hope, but here is my story. I am an avid mountain biker, age 54, generally in pretty good shape. In June 2008 I went for my annual physical only to find out I was in a-fib, I did not even know it (called asymptomatic a-fib). Thus my saga began. Symptoms became progressively worse, I think there is a strong link between the mental and physical here, but I am glad I found out because being and staying in a-fib increases your risk of stroke 5 times compared to the normal population. My doc started me on warfarin (yuk, but minimizes stroke risk) and Toprolol (lowers heart rate).Tried several cardioversions and only stayed in a sinus rhythm for one or two weeks. Went for consult at the Cleveland Clinic and they recommended starting on Tikosyn (a new anti-arhythmic), which requires a 3 day hospital stay to load up because in rare cases it puts people in ventricular fibrillation (very bad, can be fatal in a few mimutes). Also kind of a hassle because it is very important to take it at pretty close to 12 hour intervals. More cardioversions but I only stayed in a sinus rhythm for 5 to 6 weeks then back into a-fib. Finally, for a number of reasons, I had a pulmonary vein ablation done by a very experienced electrophysiologist,David Delurgio, at Emory Midtown in Atlanta in April 2009. All in I had had 7 cardioversions. My decisions was based upon the fact that my life was too disrupted and I was missing too much work due to almost monthly cardioversions and I hated being on warfarin (when I wrecked I bled like I had been shot ! and I hated the periodic INR checkups). Now, six months later, no a-fib since the procedure. I think I am cured. I ahve dropped off the warfarin and the Toprolol and am on a reduced Tikosyn dose. I expect i will drop that soon. I had one episode of a sustained delevated heart rate of about 90 after a really long ride, but when I woke up the next morning I was fine. So, ablations can work. I think it is very important to go to the right physician, someone who has great experience in doing them.

my wife had this issue---prevented her from training and racing. Three months ago she had the ablation procedure. Since then no Affib at all. She was on a monitoring device that confirmed no problem. This result is much better than usual---I attribute it to the skill of the Doc here in Tampa---Dr bengt Herwig

What kind of ablation did you undergo? PVI or something more advanced?

I've been battling Afib for about 5 years---used to be a episodic occurrence monthly, which I could control via fleccainaide & atenol, but since resuming serious training about 6 months ago it has become a serious PITA. I've tried all the meds, including the newest, Multaq, and they all suck. At best they make afib livable but with little chance of serious AnThr type training. Just completed a 6 week schedule on Multaq & my avg HR was down over 25 beats vs previous months, and power dropped about 15% as well. High suck-age factor.

I'm scheduled for ablation on November 11 with Dr. Koonlawee Nademanee---supposedly one of the top 2 guys for ablation in the U.S., and the one who invented/perfected the whole Complex Fractionated Atrial Electrograms system (basically a 3-D mapping of your heart). I looked at PVI & most of the other 2D surgeries, but the results were so-so at best. Nademanee supposedly has a 90%+ success rate after 2-3 procedures (and almost 80% after 1), so am crossing my fingers.

Would be interested to know from the other posters on this topic what kind of ablation you underwent, what the recovery times are like, and what your end result is? ____________ “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.” John Rogers

I am now 15 weeks post procedure and all is going well. No issues since the single post procedure cardioversion. Was taken off Wafarin week 13, Toporol week 14 and only take 81 mg. aspirin daily. Jury is still out regarding what improvement I will experience training until I have adjusted to training without the drugs. I have slowly increased mileage and pace and have not yet reached pre-procedure performance levels. That has a lot to do with my conservative approach and this being the off season. I am gaining confidence and will consider the procedure a success if I pass the 9 month anniversary with no new episodes.

I was diagnosed AFib in 2003 when I was 36, but I'm not sure when I actually had it. I've been on warfarin and digoxin since then.

Last year I had my first pulmonary vein ablation and it converted me to sinus, but it only lasted for 24 hours. My doctor did a cardioversion the next day, it didn't convert.

On Jan 25, 2010 (few days ago) I had my 2nd ablation, it failed again. My doctor performed 3 cardioversions before I woke up. Failed. So I was put with amiodarone for 2 days and went on 3 more cardioversions. They all failed.

It might sound painful to you to have all these done within 3 days, I wouldn't mind if they brought me back to sinus. Now I'm on amiodarone watch for 30 days, will it convert me to sinus?

Is here anyone has similar situation like me?

I'm not sure if ablation is not working on me or I need the 3rd or 4th attempt. My doctor told me my case is rarer then some patients. I'm about to turn 44.

I really hope to be drug free for the rest of my life, if anyone knows an alternative please share with me.

Thanks, EW

PS--I'm concerned about amiodarone since it has side effects and it meant for life threatening patients, am I wrong?

I've had to deal with intermittent A Fib for 5-6yrs. My regiment now is low dose asa daily and propafenone 300mg 2 as needed for A Fib. It is a med not without side effects but it works for me and converts to sinus within 3hrs. As with your experience my cardiologist feels ablation is not perfected well enough for me to try(and he does the proceedure) I've done some w/o's in A Fib but have not been when starting a race although I did go into A Fib about 5min into the swim at Clearwater and had to back off to finish.

My ablation was a huge success after I battled intermittent a-fib for years. Two failed electro cardioversions and several failed chemical conversion regimes led me to the catheter ablation. The ablation literally changed my life. My training/racing and job have finally settled down. Recovery was quick. Doc said do anything I want to the next day but I still took it easy for a week or so. Biggest concern were the stitches from the groin insertions. My a-fib would only appear when I was racing or training hard so I couldn't wait to run a fast 5k and see if the ablation really worked, which it did. This was about 10 days after the surgery.

Had only a few pvc's after my surgery and resting heart rate went from 45 to 68, where it has remained for the last 14 months. I believe quitting the beta-blocker I was taking prior to the surgery is mostly responsible for the rise in rhr.

As far as side effects: the prostititus I got from the Foley tube was a real buzzkill.

Anyone considering doing this -find the best Dr. you can. This surgery was a bigger deal than I thought it was going to be and I doubt I would want to go through it again if it didnt work the first time.

Coming up on 2 months post surgery & I have nothing but the highest recs for Dr. Koonlawee Nadamanee. Surgery is really, really cool---basically the operating room is like something out of Star Trek---about as high-tech as you can get. Procedure lasted 4 hours. Dr Wee does NOT recommend just a simple PV procedure---do a bit of research & the results of his mapping technique vs PV speak for themselves.

First day after I was a bit sore, and ginger as had some bruising/swelling where the catheters went in on my groin. Had intermittent & frequent Afib for about 1 week after---historically my Afib would die out after 12-18 hours--these were going away after 10-60min---however they were pretty frequent--2-3x a day. I was told this was normal. After 2 weeks I wasn't experiencing Afib anymore, and was cleared to begin gentle exercise. Of course I went for a 2 hour ride day 1 & scared the crap out of myself--60 minutes in went into the highest Vtach I've ever had--300+ HR for about 20 min---just couldn't shake it. Really not a good feeling. Off the bike for another week. Then I started slowly again. Total mileage in November was 110 miles. Post Vtach episode, went into Afib once more---day after Thanksgiving (due to caffeine, travel, lots of wine, and lots of pumpkin pie & holiday sweets). Self corrected after 6 hours. Took myself off Coumadin on December 1, as didn't want to risk riding & crashing while on it. Doc was fine when I told him 2 weeks later as my chance of stroke from clotting from Afib was extremely low.

December was very good---slowly built the bike riding up, and got in 2 runs. 450 miles in December, including some very high efforts. Only went into Afib once---day after xmas, eating lots of left-over xmas chocolate after heavy wine drinking on xmas day. Self-corrected after 30 min. January has been very good---almost 1k miles on the bike, and only went into Afib once---day before yesterday after digging myself a serious hole with 4 straight days of high intensity riding/racing, and 200+ miles (with one big night of wine drinking the day before I went into Afib). This episode last 20 min, but then came back in the middle of the night for about 4 hours. However I was absolutely exhausted by the miles/effort on the bike + the usual triggers (for me) of alcohol + caffeine + sugar.

The difference between before & after is night & day. Pre surgery I was going into Afib 3-4x a week, with each epsiode lasting 12-18 hours. ANY hard efforts on the bike would trigger it mid-ride--and was starting to experience some scary Vtach episodes (watching your HR on a anerobic climb skyrocket from 180 to 250+ is not a good feeling).

They say the total healing time is up to 6 months. Maybe with PV. I'm at about 90% of where I was fitness-wise pre surgery. The rest in November was good for my body, however I gained 8lbs, and am having a heck of a time dropping them so far in January.

There was an article that just came out that said that if meds don't work, you should have the surgery. I don't know anyone for who the meds work enough to let you train at a high level. The surgery is great, and Dr. Wee is one of the 2 Docs in the US I would have trusted (the other is in San Fran/Austin). Make sure you have good PPO insurance though, as the surgery is REALLY expensive. ____________ “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.” John Rogers

sorry to hear your story. Ablation seems to work best on those who have not been in a fib that long. I was always able recognize when I went into the abnormal rhythm and insisted on immediate cardioversion. I never wanted to be in a fib for any longer than a few hours. I did have one recurrance in November after a drank a beer (alcohol was my main trigger). I got cardioverted right away and it hasn't been back since. Good Luck.

Whats your definition of occasional afib? I was going into it 2-4x per week. My Dr's experience is that for some, especially bigger guys + ex-swimmers, once you start down the afib road it is only going to get worse & most meds aren't really effective (yes they help control it, but certainly don't prevent it or give you that much of a better quality of life). ____________ “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.” John Rogers

I've had 2-3/wk but that is not the rule. Last year I didn't have an episode from Dec 2008 until early July 2009 and then seemed like I was having at least one/per wk or 2. Always controled with propafenone 600mg taken when I noticed the A Fib(in some cases after I would have to fight off the denial demon) I thought for a while my triggers were alcohol and/or caffene but I have challenged with them on several occasions with no A Fib occuring. The only things I can relate are perhaps hydration and electrolytes but because of the sporatic nature I may never know for sure. The propafenone converts me to sinus within 3hrs. I've had episodes that occur while running and resolve within 5min on it's own. I think I have only gone into A Fib once while in a race and that was Clearwater. Had to back off to finish and once I got back to the hotel converted within 20min of taking med which probably means it spontaniously converted because that was a little quick for the med to have worked.

i started with a-fib about seven years ago. was sporadic (maybe once a month) but for some reason this past summer i would go into a-fib after (or during) almost every workout.

went with the cardiac ablation in October. like another poster noted, my dr. advised that i had no limitations once the incisions in the groin area were healed. interestingly, the incisions were so small that they did not require stitches. got in the pool a week after the ablation and was running/biking full speed within ten days.

talk about a modern-day miracle. i can't get my HR up as high as i used to but being able to sleep through the night and finish a swim/ride/run without having to stare at my HR monitor is truly a blessing.

as others have said, ablation is very common. they were doing 39 at my facility the day i was in there. but, most of those are done by a handful of specialists. that's who you want to see.

I completely agree re modern miracle. 100% difference after vs before. As to HR---I actually seem to be able to go higher---hit 189 3x on my Saturday group ride---highest I've seen in years. Part of it is my fitness is finally coming around, but also I also now have confidence in my body that I'm not going to spontaneously combust into Vtach, or worse.

I would venture to guess, based on the success ratios + the # of Dr.'s who are becoming proficient at it, that within 5 years ablation is pretty common & the first line of attack vs years of trying meds. ____________ “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.” John Rogers